Comparative study of intravenous thrombolysis with rt-PA and urokinase for patients with acute cerebral infarction

• Published in: Journal of international medical research Vol. 48; no. 5; p. 300060519895352
• Main Authors: Sun, Fan, Liu, Heng, Fu, Hui-xiao, Zhang, Shuo, Qian, Xu-dong, Li, Jia-jia, Zhu, Yun-bo, Zhang, Xiao-xuan, Zhang, Jian, Qiu, Hai-peng, Kang, Ling-ling, Hu, Ya-jun, Zhao, Liang, Mi, Yan-juan, Gao, Yan-jun, Dou, Zhi-jie, Ma, Zheng
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.05.2020; Sage Publications Ltd; SAGE Publishing
• Subjects: Administration, Intravenous; Adult; Aged; Biomarkers - blood; Cerebral Infarction - blood; Cerebral Infarction - complications; Cerebral Infarction - therapy; Female; Hemorrhage; Humans; Intracranial Hemorrhages - blood; Intracranial Hemorrhages - epidemiology; Intracranial Hemorrhages - etiology; Intracranial Hemorrhages - prevention & control; Male; Middle Aged; Recombinant Proteins - administration & dosage; Retrospective Clinical Research Report; Retrospective Studies; Stroke; Thrombolytic Therapy - adverse effects; Thrombolytic Therapy - methods; Thrombosis; Tissue Plasminogen Activator - administration & dosage; Tissue Plasminogen Activator - adverse effects; Treatment Outcome; United Kingdom - epidemiology; Urokinase-Type Plasminogen Activator - administration & dosage; Urokinase-Type Plasminogen Activator - adverse effects; United Kingdom; recombinant tissue plasminogen activator; Intravenous thrombolysis; MMP-9; acute cerebral infarction; urokinase; cerebral haemorrhage
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060519895352

Objective Cerebral infarction has a poor prognosis and causes a serious burden on families and society. Recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) are commonly used thrombolytic agents in the clinic. However, direct and powerful clinical trial evidence to determine the therapeutic effect of rt-PA and UK on intravenous thrombolysis is lacking. Methods In this study, 180 patients with acute cerebral infarction were treated with rt-PA or UK. The National Institutes of Health Stroke Scale (NIHSS) scores, Barthel index, bleeding complications, and biomarkers were evaluated. Results No significant differences in NIHSS or Barthel scores were found between the groups. However, UK increased the risk of intracranial haemorrhage compared with rt-PA. rt-PA had increased activity in reducing serum levels of MMP-9 than UK. Conclusion Intravenous thrombolysis with rt-PA and UK in the time window of acute cerebral infarction can achieve similar therapeutic effects, but rt-PA can further reduce the risk of cerebral haemorrhage and is relatively safer than UK.